CENTRACARE HEALTH SYSTEM: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
CENTRACARE HEALTH SYSTEM (EIN 41-1813221)
Tax period
2018-07-01 to 2019-06-30
Filed
2020-05-13
IRS object ID
202001349349302310
Schema version
2018v3.1
Note
A later return for the same period supersedes this one.
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2020-05-13T11:17:05-05:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN420714325PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1RSM US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1801 NICOLLET MALL WEST TOWER STEAddressLine1Txt
Address Line21100AddressLine2Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554022526ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN411813221EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CENTRACARE HEALTH SYSTEMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCENTBusinessNameControlTxt
Phone3202512700PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11406 6TH AVENUE NORTHAddressLine1Txt
CityST CLOUDCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56303ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHAEL A BLAIRPersonNm
Person TitleCFO/TREASURERPersonTitleTxt
Phone3202512700PhoneNum
Signature2020-05-08SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKACIE MCEWENPreparerPersonNm
PTINP01599614PTIN
Phone6123324300PhoneNum
Preparation2020-05-08PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address174.219.32.236IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-05-08IPDt
IP Tm17:18:53IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device IdB56786F7D21A8F39D00ED83C272556B8DDCB8C36AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKENNETH D HOLMEN MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11406 6TH AVENUE NORTHAddressLine1Txt
CityST CLOUDCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56303ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$412,315,215GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CENTRACARE.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1995FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionINTEGRATED MULTI-ORGANIZATIONAL HEALTH CARE SYSTEM DESIGNED TO PROVIDE ACCESS TO QUALITY HEALTH CARE SERVICES AT AN AFFORDABLE PRICE.ActivityOrMissionDesc
Voting Members Governing Body20VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee5510TotalEmployeeCnt
Total Volunteers447TotalVolunteersCnt
Total Gross UBI$8,639,313TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$495,477NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,867,541PYContributionsGrantsAmt
CY Contributions Grants$3,676,019CYContributionsGrantsAmt
PY Program Service Revenue$292,511,337PYProgramServiceRevenueAmt
CY Program Service Revenue$382,942,376CYProgramServiceRevenueAmt
PY Investment Income$4,234,522PYInvestmentIncomeAmt
CY Investment Income$6,661,511CYInvestmentIncomeAmt
PY Other Revenue$8,858,624PYOtherRevenueAmt
CY Other Revenue$9,271,798CYOtherRevenueAmt
PY Total Revenue$307,472,024PYTotalRevenueAmt
CY Total Revenue$402,551,704CYTotalRevenueAmt
PY Grants And Similar Paid$344,074PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$149,920CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$161,364,843PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$206,406,426CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$142,537,613PYOtherExpensesAmt
CY Other Expenses$183,066,564CYOtherExpensesAmt
PY Total Expenses$304,246,530PYTotalExpensesAmt
CY Total Expenses$389,622,910CYTotalExpensesAmt
PY Revenues Less Expenses$3,225,494PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$12,928,794CYRevenuesLessExpensesAmt
Total Assets BOY$431,777,761TotalAssetsBOYAmt
Total Assets EOY$516,087,917TotalAssetsEOYAmt
Total Liabilities BOY$280,015,582TotalLiabilitiesBOYAmt
Total Liabilities EOY$315,760,094TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$151,762,179NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$200,327,823NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionWE'RE HERE FOR YOUR WHOLE LIFE TO LISTEN, THEN SERVE, TO GUIDE AND HEAL BECAUSE HEALTH MEANS EVERYTHING.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$105,589,520ExpenseAmt
Grant$35,800GrantAmt
Revenue$115,424,110RevenueAmt
DescCENTRACARE HEALTH SYSTEM (CCHS) IS AN INTEGRATED HEALTH SYSTEM, INCLUDING SHARED SERVICES WITHIN IT'S NETWORK, SUCH AS LABORATORY SERVICES, A SURGICAL CENTER, A NETWORK COLLABORATION.CENTRACARE LABORATORY SERVICES ALL HOSPITALS UNDER ITS UMBRELLA AS WELL AS CENTRACARE CLINIC. IT ALSO PERFORMS TESTS FOR VARIOUS FACILITIES IN THE REGION. CENTRACARE LABORATORY PERFORMED 1,986,853 TESTS IN FISCAL YEAR 2019. IN FISCAL YEAR 2019 CENTRACARE LABORATORY GENERATED $46,415,616 IN PROGRAM REVENUE AND INCURRED $28,854,183 OF EXPENSES.CENTRACARE SURGICAL CENTER PROVIDES ELECTIVE SURGERY PROCEDURES TO PATIENTS IN THE CENTRAL MN REGION. IN FY 2019, THE CENTER PERFORMED 6,162 SURGERIES AND GENERATED $12,503,649 OF PROGRAM REVENUE AND $11,384,234 OF PROGRAM EXPENSE.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$120,184,573ExpenseAmt
Grant$64,038GrantAmt
Revenue$142,757,656RevenueAmt
DescCARRIS HEALTH - RICE MEMORIAL HOSPITAL IS A SUBSIDIARY OF CENTRACARE AS OF 1/1/2018 THAT HAS 136 LICENSED BEDS, CARED FOR 3,235 INPATIENT ADMISSIONS WITH 10,956 ASSOCIATED PATIENT DAYS DURING FISCAL YEAR 2019. INPATIENT SERVICES INCLUDE MEDICAL AND SURGICAL CARE, BIRTHING SERVICES, PEDIATRIC SERVICES, BEHAVIORAL HEALTH CARE SERVICES, AND REHABILITATION SERVICES. OUTPATIENT ENCOUNTERS DURING FISCAL YEAR 2019 WERE 41,149 AND INCLUDED EMERGENCY ROOM SERVICES, DIALYSIS, IMAGING, RESPIRATORY THERAPY, A REHABILITATION CENTER, SAME DAY SURGERY AND OTHER AMBULATORY CARE SERVICES. CARRIS HEALTH ALSO OFFERS A CERTIFIED SKILLED NURSING FACILITY LOCATED IN WILLMAR, MN, THE FACILITY HAS 78 LICENSED BEDS AND HAS REALIZED 17,130 RESIDENT DAYS IN THE LONG-TERM CARE PORTION OF THE FACILITY AND 8,843 RESIDENT DAYS IN THE SHORT-TERM THERAPY SUITES AREA DURING FISCAL YEAR 2019. CARRIS HEALTH ALSO HAS AN ACCREDITED AMBULATORY SURGICAL CENTER LOCATED IN WILLMAR, MN. CARRIS HEALTH SURGICAL CENTER COMPLETED 6,030 OUTPATIENT (SAME DAY) PROCEDURES. CARRIS HEALTH ALSO HAD A DURABLE MEDICAL EQUIPMENT PROVIDER, RICE HOME MEDICAL. RICE HOME MEDICAL IS A LEADING RETAIL PROVIDER OF MEDICAL EQUIPMENT AND SUPPLIES THROUGHOUT WESTERN MINNESOTA. RICE HOME MEDICAL WAS FOUNDED IN 1988 AND IS HEADQUARTERED IN WILLMAR, MN. RICE HOME MEDICAL OFFERS MEDICAL EQUIPMENT AND SUPPLIES FOR RESPIRATORY, MOBILITY, COMPLEX MOBILITY, WOMEN'S HEALTH, INDEPENDENT LIVING, HOME MODIFICATIONS AND OTHER HEALTHCARE RELATED EQUIPMENT AND SERVICES. RICE HOME MEDICAL HAS LOCATIONS IN WILLMAR, ALEXANDRIA, REDWOOD AND MADISON, MN. EACH YEAR IT SERVES MORE THAN 20,000 PATIENTS. RICE HOME MEDICAL BECAME A SUBSIDIARY OF CANTRACARE HOLDINGS ON 1/1/2019 AND IS NO LONGER CONSOLIDATED AS A PART OF CARRIS HEALTH. AS OF JANUARY 1, 2019 CARRIS HEALTH - REDWOOD AREA HOSPITAL JOINED CENTRACARE. CARRIS HEALTH REDWOOD AREA HOSPITAL HAS 25 LICENSED BEDS AND CARED FOR 286 INPATIENT ADMISSIONS WITH 879 ASSOCIATED PATIENT DAYS JANUARY THROUGH JUNE 2019. INPATIENT SERVICES INCLUDE MEDICAL AND SURGICAL CARE, BIRTHING SERVICES, PEDIATRIC SERVICES, BEHAVIORAL HEALTH CARE SERVICES, AND REHABILITATION SERVICES. OUTPATIENT ENCOUNTERS DURING FISCAL YEAR 2019 WERE 11,215 AND INCLUDED EMERGENCY ROOM SERVICES, IMAGING, RESPIRATORY THERAPY, CANCER CARE/INFUSION, A REHABILITATION CENTER, SAME DAY SURGERY AND OTHER AMBULATORY CARE SERVICES.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$59,942,195ExpenseAmt
Grant$31,962GrantAmt
Revenue$75,118,667RevenueAmt
DescMONTICELLO HOSPITAL IS CONSIDERED A DISREGARDED ENTITY FOR PURPOSES OF 990 REPORTING, THUS IT IS INCLUDED WITH THIS 990 FILING. MONTICELLO HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL AND ALSO OPERATES A 10 BED ACUTE GERIATRIC PSYCHIATRIC UNIT. IN FISCAL YEAR 2019, THEY HAD 7,123 PATIENT DAYS, 31,205 OUTPATIENT VISITS AND 12,326 EMERGENCY ROOM VISITS' WHICH GENERATED $73,206,648 OF PROGRAM REVENUE AND $71,716,371 OF PROGRAM EXPENSES.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$32,878,995ExpenseAmt
Grant$18,120GrantAmt
Revenue$41,347,076RevenueAmt
DescCENTRACARE HEALTH - PAYNESVILLE HOSPITAL IS CONSIDERED A DISREGARDED ENTITY FOR PURPOSES OF 990 REPORTING, THUS IT IS INCLUDED WITH THIS 990 FILING. CENTRACARE HEALTH - PAYNESVILLE HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL. IN FISCAL YEAR 2019 THEY HAD 2,492 PATIENT DAYS, 40,247 OUTPATIENT VISITS AND 3,570 EMERGENCY ROOM VISITS. IN FISCAL YEAR 2019, PAYNESVILLE GENERATED $40,672,343 OF PROGRAM REVENUE AND $37,774,050 OF PROGRAM EXPENSE.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$32,878,995TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$18,120TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$41,347,076TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$318,595,283TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document481IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee5510EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members20GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local ChaptersYes (1)LocalChaptersInd
Policies Reference ChaptersYes (1)PoliciesReferenceChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MICHAEL BLAIRBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3202512700PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11406 SIXTH AVENUE NORTHAddressLine1Txt
CityST CLOUDCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56303ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (46 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
KENNETH D HOLMEN MD
PRESIDENT/CEO21.0019.00Yes (X)Yes (X)$1,455,450$0$29,053
MIKE BENUSA
DIRECTOR/CHAIR2.000.00Yes (X)Yes (X)$4,000$0$0
STEVE LARAWAY
DIRECTOR/VICE CHAIR2.000.00Yes (X)Yes (X)$1,500$0$0
DAVID ANFINSON
DIRECTOR2.000.00Yes (X)$1,000$0$0
TERESA BOHNEN
DIRECTOR2.000.00Yes (X)$1,500$0$0
CHRISTOPHER COBORN
DIRECTOR2.000.00Yes (X)$1,000$0$0
JEFF GAU
DIRECTOR2.000.00Yes (X)$1,000$0$0
TIM HEBL MD
DIRECTOR2.000.00Yes (X)$0$0$0
MARY DANA HINTON
DIRECTOR2.001.00Yes (X)$0$0$0
DONALD JURGENS MD
DIRECTOR/PHYSICIAN2.0038.00Yes (X)$0$910,755$36,439
DONALD KETTLER JCL
DIRECTOR2.000.00Yes (X)$0$0$0
BRYAN ROLPH
DIRECTOR/PHYSICIAN40.000.00Yes (X)$0$444,739$48,694
DENISE ROSIN
DIRECTOR2.000.00Yes (X)$0$0$0
SHARON RUGGIERO MD
DIRECTOR/PHYSICIAN2.0038.00Yes (X)$0$264,394$28,399
CHRISTIAN SCHMIDT MD
DIRECTOR/SURGEON2.0038.00Yes (X)$0$678,438$42,685
TOHOW SIYAD
DIRECTOR2.000.00Yes (X)$0$0$0
ROBERT STOCKER MD
DIRECTOR/OBGYN2.000.00Yes (X)$0$0$0
RICHARD WEHLSER MD
DIRECTOR/PHYSICIAN2.0038.00Yes (X)$0$381,423$15,876
JOSEPH UPHUS
DIRECTOR2.000.00Yes (X)$1,500$0$0
TIMOTHY WENSMAN
DIRECTOR2.000.00Yes (X)$0$0$0
PAUL R HARRIS ESQ
CORPORATE SECRETARY25.0015.00Yes (X)$573,539$0$309,499
GREGORY R KLUGHERZ
TREASURER/CFO25.0015.00Yes (X)$756,425$0$33,266
CHRISTOPHER BOELTER MD
VICE PRESIDENT20.0020.00$656,989$0$20,625Yes (X)
JOSEPH M BLONSKI MD
VICE PRESIDENT20.0020.00$456,040$0$211,712Yes (X)
DIANE R BUSCHENA-BRENNA
VICE PRESIDENT20.0020.00$202,196$0$32,329Yes (X)
ANTHONY V GARDENER
VICE PRESIDENT20.0020.00$359,403$0$154,793Yes (X)
JOSEPH D HELLIE
VICE PRESIDENT20.0020.00$0$373,409$188,324Yes (X)
BETH A HONKOMP
VICE PRESIDENT20.0020.00$309,501$0$37,117Yes (X)
JOSEPH H KALKMAN
VICE PRESIDENT20.0020.00$393,631$0$172,330Yes (X)
BRADLEY J KONKLER
VICE PRESIDENT20.0020.00$324,129$0$164,451Yes (X)
DAVID A LARSON
VICE PRESIDENT20.0020.00$0$206,177$102,618Yes (X)
KELLY MACKEN-MARBLE
VICE PRESIDENT20.0020.00$368,032$0$135,140Yes (X)
MARK S MATTHIAS MD
VICE PRESIDENT20.0020.00$660,432$0$82,283Yes (X)
GEORGE A MORRIS MD
VICE PRESIDENT20.0020.00$511,919$0$189,815Yes (X)
KURT OTTO MD
VICE PRESIDENT20.0020.00$396,576$0$206,395Yes (X)
KATHLEEN M PARSONS
VICE PRESIDENT20.0020.00$297,825$0$92,114Yes (X)
JOY PLAMANN
VICE PRESIDENT20.0020.00$317,953$0$186,845Yes (X)
AMY M PORWOLL
VICE PRESIDENT20.0020.00$497,075$0$243,961Yes (X)
MICHAEL W SCHRAMM
CARRIS HEALTH, PRESIDENT/CO-CEO40.000.00$439,269$0$86,957Yes (X)
THOMAS SCHRUP MD
VICE PRESIDENT20.0020.00$457,851$0$166,715Yes (X)
CINDY FIRKINS SMITH MD
CARRIS HEALTH, PRESIDENT/CO-CEO40.000.00$0$811,048$155,226Yes (X)
NELSON L ADAMSON MD
PHYSICIAN40.000.00$0$546,571$38,739Yes (X)
JONATHAN W MELLEMA MD
PHYSICIAN40.000.00$0$582,080$16,633Yes (X)
LEAH M SCHAMMEL MD
PHYSICIAN40.000.00$0$713,709$19,326Yes (X)
JULIE C SCHULTZ MD
PHYSICIAN40.000.00$0$698,652$25,608Yes (X)
NATHANIEL J SLINKARD MD
PHYSICIAN40.000.00$0$632,502$10,074Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$9,445,735TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$7,243,897TotReportableCompRltdOrgAmt
Total Other Compensation$3,284,041TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K410IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MAYO COLLABORATIVE SERVICES
PO BOX 4100ROCHESTERMN559034100LABORATORY SERVICES$3,581,440
METRO ANESTHESIA CONSULTANTS
9855 AETNA AVE NEMONTICELLOMN55362ANESTHESIA SERVICES$3,303,280
CENTRACARE CLINIC
1200 6TH AVE NST CLOUDMN56303PHYSICIAN SERVICES$2,990,394
HURON CONSULTING SERVICES LLC
3005 MOMENTUM PLACECHICAGOIL606895330CONSULTING SERVICES$2,115,509
STELLIS HEALTH PA
1700 HIGHWAY 25 NORTHBUFFALOMN55313PHYSICIAN SERVICES$1,547,474
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K55CntrctRcvdGreaterThan100KCnt
Related Organizations$122,092RelatedOrganizationsAmt
Government Grants$1,232,985GovernmentGrantsAmt
All Other Contributions$2,320,942AllOtherContributionsAmt
Total Contributions$3,676,019TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT & SERVICE REVENUE621110$324,761,026$323,600,480$1,160,546
HEALTH INSURANCE PREMIUM CREDIT621110$32,530,669$32,530,669
SHARED/LEGAL SYSTEM REVENUE621110$25,650,681$18,516,360$7,134,321
FieldValueIRS element (for citing)
Total Program Service Revenue$382,942,376TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,487,080TotalRevenueColumnAmt
Exclusion$4,487,080ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$10,148,168RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$9,445,524RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$702,644RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$702,644TotalRevenueColumnAmt
Exclusion$702,644ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,187,931SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$13,500OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$2,187,931SecuritiesAmt
Other-$13,500OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,174,431TotalRevenueColumnAmt
Exclusion$2,174,431ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$1,819,033GrossSalesOfInventoryAmt
Cost Of Goods Sold$304,487CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,514,546TotalRevenueColumnAmt
Exclusion$1,514,546ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
ALL OTHER REVENUE900099$4,874,606$344,446$4,530,160
OTHER SERVICES SOLD900099$2,004,075$2,004,075
REVENUE FROM JOINT VENTURES900099$175,927$175,927
FieldValueIRS element (for citing)
Other Revenue Total$7,054,608OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$402,551,704TotalRevenueColumnAmt
Related Or Exempt Func Income$374,647,509RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$8,639,313UnrelatedBusinessRevenueAmt
Exclusion$15,588,863ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$116,691TotalAmt
Program Services$116,691ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$33,229TotalAmt
Program Services$33,229ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$11,910,151TotalAmt
Program Services$9,355,787ProgramServicesAmt
Management And General$2,554,364ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$109,044,527TotalAmt
Program Services$85,657,806ProgramServicesAmt
Management And General$23,386,721ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$12,690,990TotalAmt
Program Services$9,969,160ProgramServicesAmt
Management And General$2,721,830ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$58,562,541TotalAmt
Program Services$46,002,664ProgramServicesAmt
Management And General$12,559,877ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$14,198,217TotalAmt
Program Services$11,153,133ProgramServicesAmt
Management And General$3,045,084ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,723,840TotalAmt
Program Services$1,354,129ProgramServicesAmt
Management And General$369,711ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$155,517TotalAmt
Program Services$122,163ProgramServicesAmt
Management And General$33,354ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$120,998TotalAmt
Program Services$120,998ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$36,342TotalAmt
Management And General$36,342ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$79,387,960TotalAmt
Program Services$62,361,667ProgramServicesAmt
Management And General$17,026,293ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$717,121TotalAmt
Program Services$563,320ProgramServicesAmt
Management And General$153,801ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,474,656TotalAmt
Program Services$1,943,918ProgramServicesAmt
Management And General$530,738ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,953,775TotalAmt
Program Services$2,320,280ProgramServicesAmt
Management And General$633,495ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$759,181TotalAmt
Program Services$596,360ProgramServicesAmt
Management And General$162,821ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$2,100,356TotalAmt
Program Services$1,649,894ProgramServicesAmt
Management And General$450,462ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$5,183,474TotalAmt
Program Services$4,071,777ProgramServicesAmt
Management And General$1,111,697ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$19,685,560TotalAmt
Program Services$15,463,609ProgramServicesAmt
Management And General$4,221,951ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,037,930TotalAmt
Program Services$815,326ProgramServicesAmt
Management And General$222,604ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
DRUGS/MEDICAL SUPPLIES$48,161,202$48,161,202
BAD DEBT$5,610,520$5,610,520
MEDICAID SURCHARGE/MN C$4,535,106$4,535,106
MINOR EQUIPMENT$2,314,201$1,817,875$496,326

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$6,108,825TotalAmt
Program Services$4,798,669ProgramServicesAmt
Management And General$1,310,156ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$389,622,910TotalAmt
Program Services$318,595,283ProgramServicesAmt
Management And General$71,027,627ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$17,182,374BOYAmt
EOY$73,547,020EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$79,128,689BOYAmt
EOY$54,063,342EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$6,661,489BOYAmt
EOY$6,932,858EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$8,532,848BOYAmt
EOY$6,737,591EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$381,271,000LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$138,554,213LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$220,603,069BOYAmt
EOY$242,716,787EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$62,073,005BOYAmt
EOY$121,743,177EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$10,347,142BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$27,249,145BOYAmt
EOY$10,347,142EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$431,777,761BOYAmt
EOY$516,087,917EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$82,134,870BOYAmt
EOY$51,542,567EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$13,865BOYAmt
EOY$13,865EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$61,766,795BOYAmt
EOY$65,423,151EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$65,495,756BOYAmt
EOY$111,658,569EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$70,604,296BOYAmt
EOY$87,121,942EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$280,015,582BOYAmt
EOY$315,760,094EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$132,866,179BOYAmt
EOY$180,133,287EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$15,297,527BOYAmt
EOY$16,451,721EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,598,473BOYAmt
EOY$3,742,815EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$151,762,179BOYAmt
EOY$200,327,823EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$431,777,761BOYAmt
EOY$516,087,917EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$12,928,794ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$1,370,523NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments-$27,293PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$37,034,666OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or ManagementYes (1)PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$120,998OtherActivitiesAmt
Total Lobbying Expenditures$120,998TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationCENTRACARE HEALTH SYSTEM PAID $120,998 TO STATE AND NATIONAL ASSOCIATIONS TO CONDUCT LOBBYING ACTIVITIES ON ITS BEHALF, AS A MEMBER OF THE ASSOCIATIONS.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,359,122OtherCostOrOtherBasisAmt
Book Value$14,359,122BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$201,592,221OtherCostOrOtherBasisAmt
Depreciation$77,935,671DepreciationAmt
Book Value$123,656,550BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$69,784,192OtherCostOrOtherBasisAmt
Depreciation$59,978,755DepreciationAmt
Book Value$9,805,437BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$61,434,227OtherCostOrOtherBasisAmt
Depreciation$526,390DepreciationAmt
Book Value$60,907,837BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$34,101,238OtherCostOrOtherBasisAmt
Depreciation$113,397DepreciationAmt
Book Value$33,987,841BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$242,716,787TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (6 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
FUNDS HELD BY TRUSTEE UNDER TRUST AND ESCROW AGREEMENT$4,145,473F
FUNDS HELD BY TRUSTEE UNDER BOND INDENTURES$59,685,076F
FUNDS HELD BY BOARD FOR FUTURE PROPERTY & EQUIP REPLACEMENT/EXPANSION$38,368,043F
INVESTMENT IN JOINT VENTURES$5,213,419C
INVESTMENT IN MUTUAL SERVICE CORP$1,211,453F
INVESTMENT IN OTHER$13,119,713F
FieldValueIRS element (for citing)
Total Book Value Securities$121,743,177TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
PENSION ACCRUAL$252,583
ASSET RETIREMENT OBLIGATION$572,577
DUE TO AFFILIATES$40,775,152
CONTINGENET CONSIDERATIONS$1,356,526
THIRD PARTY SETTLEMENTS$2,853,972
INTERST PAYABLE$41,311,132
FieldValueIRS element (for citing)
Total Liability$87,121,942TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationCENTRACARE, THE CORPORATION, THE CLINIC, CCH - MELROSE, CCH - LONG PRAIRIE, CCH - SAUK CENTRE AND THE FOUNDATION HAVE BEEN DETERMINED TO QUALIFY AS TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CCH - MONTICELLO, CCH - PAYNESVILLE AND CARRIS HEALTH, AS DISREGARDED LIMITED LIABILITY COMPANIES (LLCS) UNDER INTERNAL REVENUE SERVICE REGULATIONS, ACHIEVE TAX-EXEMPT TREATMENT BASED ON THE EXEMPT STATUS OF THEIR PARENT, CENTRACARE HEALTH SYSTEM. AT JUNE 30, 2019 AND 2018, THERE WERE NO UNCERTAIN TAX POSITIONS.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other175.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent250Yes (X)Percent250Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$558,310TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$558,310NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$43,826,586TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$35,854,370DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,972,216NetCommunityBenefitExpnsAmt
Total Expense0.02080TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$44,384,896TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$35,854,370DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,530,526NetCommunityBenefitExpnsAmt
Total Expense0.02230TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$48,251TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$48,251NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$161,968TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$161,968NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$416,850TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$416,850NetCommunityBenefitExpnsAmt
Total Expense0.00110TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$627,069TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$627,069NetCommunityBenefitExpnsAmt
Total Expense0.00160TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$45,011,965TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$35,854,370DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,157,595NetCommunityBenefitExpnsAmt
Total Expense0.02390TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$304TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$304NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$304TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$304NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$5,610,520BadDebtExpenseAmt
Reimbursed By Medicare$63,321,309ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$68,171,399CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$4,850,090MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities4HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (4 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdWebsite AddressWebsiteAddressTxtState LicenseStateLicenseNumLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndCritical Access HospitalCriticalAccessHospitalIndEmergency Room24 HrsEmergencyRoom24HrsIndOtherOtherDesc
CENTRACARE HEALTH - MONTICELLO
11013 HART BLVDMONTICELLOMN55362WWW.CENTRACARE.COM/LOCATIONS/MONTICELL389601Yes (X)Yes (X)Yes (X)Yes (X)DISTINCT PART REHAB
CENTRACARE HEALTH - PAYNESVILLE
2200 WEST FIRST STREETPAYNESVILLEMN56362WWW.CENTRACARE.COM/LOCATIONS/PAYNESVIL389921Yes (X)Yes (X)Yes (X)Yes (X)
CARRIS HEALTH - RICE MEMORIAL HOSPITAL
3301 BECKER AVE SWWILLMARMN56201WWW.CARRISHEALTH.COM/LOCATIONS/CARRIS-385035Yes (X)Yes (X)Yes (X)
CARRIS HEALTH - REDWOOD AREA HOSPITAL
4100 FALLWOOD ROADREDWOOD FALLSMN56283CARRISHEALTH.COM/LOCATIONS/CARRIS-HEAL389777Yes (X)Yes (X)Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (4 entries)

FacilityFacilityNumFirst Licensed CY Or PYFirstLicensedCYOrPYIndTax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYIndCHNA ConductedCHNAConductedIndCommunity DefinitionCommunityDefinitionIndCommunity DemographicsCommunityDemographicsIndHow Data ObtainedHowDataObtainedIndCommunity Health NeedsCommunityHealthNeedsIndOther Health IssuesOtherHealthIssuesIndCommunity Hlth Needs Id ProcessCommunityHlthNeedsIdProcessIndOtherOtherIndCHNA ConductedCHNAConductedYrTake Into Account Others InputTakeIntoAccountOthersInputIndCHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsIndCHNA Conducted With Non FcltsCHNAConductedWithNonFcltsIndCHNA Report Widely AvailableCHNAReportWidelyAvailableIndRpt Available On Own WebsiteRptAvailableOnOwnWebsiteIndOwn Website URLOwnWebsiteURLTxtPaper Copy Public InspectionPaperCopyPublicInspectionIndImplementation Strategy AdoptImplementationStrategyAdoptIndImplementation Strategy AdptImplementationStrategyAdptYrStrategy Posted WebsiteStrategyPostedWebsiteIndStrategy Website URLStrategyWebsiteURLTxtOrganization Incur Excise TaxOrganizationIncurExciseTaxIndElig Criteria ExplainedEligCriteriaExplainedIndFPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntIndFPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePctFPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePctInsurance Status CriteriaInsuranceStatusCriteriaIndOther CriteriaOtherCriteriaIndExplained BasisExplainedBasisIndApp Financial Asst ExplnAppFinancialAsstExplnIndDescribed InfoDescribedInfoIndDescribed Suprt DocDescribedSuprtDocIndProvided Hospital ContactProvidedHospitalContactIndIncludes Publicity MeasuresIncludesPublicityMeasuresIndFAP Available On WebsiteFAPAvailableOnWebsiteIndFAP Available On Website URLFAPAvailableOnWebsiteURLTxtFAP App Available On WebsiteFAPAppAvailableOnWebsiteIndFAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxtFAP Summary On WebsiteFAPSummaryOnWebsiteIndFAP Summary On Website URLFAPSummaryOnWebsiteURLTxtFAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeIndFAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgIndFAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgIndNotified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayIndCommuntity Notified FAPCommuntityNotifiedFAPIndFAP TranslatedFAPTranslatedIndOther PublicityOtherPublicityIndFAP Actions On NonpaymentFAPActionsOnNonpaymentIndCollection ActivitiesCollectionActivitiesIndMade Effort Orally NotifyMadeEffortOrallyNotifyIndProcessed FAP ApplicationProcessedFAPApplicationIndMade Presumptive Elig DetermMadePresumptiveEligDetermIndNondis Emergency Care PolicyNondisEmergencyCarePolicyIndLook Back Medicare PrivateLookBackMedicarePrivateIndAmounts Generally BilledAmountsGenerallyBilledIndGross ChargesGrossChargesIndRpt Available Thru Other MethodRptAvailableThruOtherMethodInd
CENTRACARE HEALTH - MONTICELLO
100Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)15Yes (1)Yes (1)0Yes (1)Yes (X)SEE SECTION C SUPPLEMENTAL INFORMATION FOR PART V, SECTION BYes (X)Yes (1)15Yes (1)SEE SECTION C SUPPLEMENTAL INFORMATION FOR PART V, SECTION B0Yes (1)Yes (X)175.000000000000250.000000000000Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCEYes (X)WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCEYes (X)WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCEYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)0Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
CENTRACARE HEALTH - PAYNESVILLE
200Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)15Yes (1)Yes (1)0Yes (1)Yes (X)SEE SECTION C SUPPLEMENTAL INFORMATION FOR PART V, SECTION BYes (X)Yes (1)15Yes (1)SEE SECTION C SUPPLEMENTAL INFORMATION FOR PART V, SECTION B0Yes (1)Yes (X)175.000000000000250.000000000000Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCEYes (X)WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCEYes (X)WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCEYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)0Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00Yes (X)
CARRIS HEALTH - RICE MEMORIAL HOSPITAL
30Yes (1)00Yes (1)Yes (X)175.000000000000250.000000000000Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)WWW.CARRISHEALTH.COM/PATIENT-RESOURCES/PRICING-FINANCIAL-ASSISTANCEYes (X)WWW.CARRISHEALTH.COM/PATIENT-RESOURCES/PRICING-FINANCIAL-ASSISTANCEYes (X)WWW.CARRISHEALTH.COM/PATIENT-RESOURCES/PRICING-FINANCIAL-ASSISTANCEYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)0Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
CARRIS HEALTH - REDWOOD AREA HOSPITAL
40Yes (1)00Yes (1)Yes (X)175.000000000000250.000000000000Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)WWW.CARRISHEALTH.COM/PATIENT-RESOURCES/PRICING-FINANCIAL-ASSISTANCEYes (X)WWW.CARRISHEALTH.COM/PATIENT-RESOURCES/PRICING-FINANCIAL-ASSISTANCEYes (X)WWW.CARRISHEALTH.COM/PATIENT-RESOURCES/PRICING-FINANCIAL-ASSISTANCEYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)0Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00

Supplemental Information SupplementalInformationGrp (21 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
CARRIS HEALTH - RICE MEMORIAL HOSPITALPART V, SECTION B, LINE 2: RICE MEMORIAL HOSPITAL WAS ACQUIRED BY CENTRACARE HEALTH AS OF JANUARY 1, 2018. PRIOR TO THE ACQUISITION RICE MEMORIAL HOSPITAL WAS A GOVERNMENTAL HOSPITAL.
CARRIS HEALTH - REDWOOD AREA HOSPITALPART V, SECTION B, LINE 2: EFFECTIVE JANUARY 1, 2019, CARRIS HEALTH AFFILIATED WITH REDWOOD AREA HOSPITAL, A DIVISION OF THE CITY OF REDWOOD FALLS, MINNESOTA, EXPANDING CARRIS HEALTH TO INCLUDE CARRIS REDWOOD.
CENTRACARE HEALTH - MONTICELLOPART V, SECTION B, LINE 3J: CCH'S CHNA PRIMARY NEEDS WERE IDENTIFIED USING THE CENTER FOR DISEASE CONTROL'S COMMUNITY HEALTH STATUS INDICATORS (CHSI). THE PROCESS ALSO CONSIDERED SECONDARY DATA FROM THE DARTMOUTH ATLAS, ROBERT WOOD JOHNSON, MINNESOTA DEPARTMENT OF HEALTH, US CENSUS BUREAU, MINNESOTA HOSPITAL ASSOCIATION, AND PUBLIC HEALTH DEPARTMENTS FROM APPROPRIATE COUNTIES AND ADDITIONAL FEDERAL AND STATE ENTITIES. THE CHNA WAS INFORMED BY A COLLABORATIVE AND ONGOING COMMUNITY HEALTH SURVEY JOINTLY FUNDED AND MANAGED WITH A NUMBER OF AREA COUNTIES WHO WERE JOINTLY CONDUCTING COMMUNITY SURVEYS TO INFORM THEIR COMMUNITY HEALTH ASSESSMENTS IN SUPPORT OF DEVELOPMENT OF THEIR COMMUNITY HEALTH IMPROVEMENT PLANS.LACK OF CURRENT PUBLIC HEALTH DATA WAS A SIGNIFICANT INFORMATION GAP IN THE CHNA AS THE SURVEY COULD NOT BE COMPLETED IN TIME TO INCLUDE ITS DATA IN THE CCH CHNA. CCH HAS COMMITTED TO A CONTINUING EFFORT WITH PUBLIC HEALTH OFFICIALS TO JOINTLY DEVELOP PRIORITIES WITH THE COUNTIES AS A PART OF ITS ACTION PLANS.
CENTRACARE HEALTH - PAYNESVILLEPART V, SECTION B, LINE 3J: CCH'S CHNA PRIMARY NEEDS WERE IDENTIFIED USING THE CENTER FOR DISEASE CONTROL'S COMMUNITY HEALTH STATUS INDICATORS (CHSI). THE PROCESS ALSO CONSIDERED SECONDARY DATA FROM THE DARTMOUTH ATLAS, ROBERT WOOD JOHNSON, MINNESOTA DEPARTMENT OF HEALTH, US CENSUS BUREAU, MINNESOTA HOSPITAL ASSOCIATION, AND PUBLIC HEALTH DEPARTMENTS FROM APPROPRIATE COUNTIES AND ADDITIONAL FEDERAL AND STATE ENTITIES. THE CHNA WAS INFORMED BY A COLLABORATIVE AND ONGOING COMMUNITY HEALTH SURVEY JOINTLY FUNDED AND MANAGED WITH A NUMBER OF AREA COUNTIES WHO WERE JOINTLY CONDUCTING COMMUNITY SURVEYS TO INFORM THEIR COMMUNITY HEALTH ASSESSMENTS IN SUPPORT OF DEVELOPMENT OF THEIR COMMUNITY HEALTH IMPROVEMENT PLANS.LACK OF CURRENT PUBLIC HEALTH DATA WAS A SIGNIFICANT INFORMATION GAP IN THE CHNA AS THE SURVEY COULD NOT BE COMPLETED IN TIME TO INCLUDE ITS DATA IN THE CCH CHNA. CCH HAS COMMITTED TO A CONTINUING EFFORT WITH PUBLIC HEALTH OFFICIALS TO JOINTLY DEVELOP PRIORITIES WITH THE COUNTIES AS A PART OF ITS ACTION PLANS.
CENTRACARE HEALTH - MONTICELLOPART V, SECTION B, LINE 5: DATA WAS OBTAINED FROM LOCAL COUNTY PUBLIC HEALTH DEPARTMENTS, INCLUDING THEIR MOST RECENT HEALTH ASSESSMENTS AND COMMUNITY REPORTS. IN ADDITION, HEALTH-RELATED INFORMATION WAS COLLECTED FROM AREA NONPROFIT ORGANIZATIONS THAT REGULARLY CONDUCT ASSESSMENTS AND EVALUATIONS OF THE SERVICES THEY PROVIDE AND THEIR TARGETED DEMOGRAPHICS. USEFUL MATERIAL WAS GATHERED FROM THE LOCAL UNITED WAY, CATHOLIC CHARITIES, THE CENTRAL MINNESOTA COUNCIL ON AGING, AND THE TRI-COUNTY ACTION PROGRAM (TRI-CAP). THESE ORGANIZATIONS SUPPORT A BROAD RANGE OF CONSTITUENTS WITH DIVERSE HEALTH-RELATED NEEDS; THEY REPRESENT DEMOGRAPHICS THAT ARE STATISTICALLY MORE LIKELY TO ENCOUNTER HEALTH-RELATED BARRIERS. CCH ALSO CONDUCTED A SERIES OF FOCUS GROUPS THAT INFORMED ITS CHNA. SPECIFICALLY, THE FOCUS GROUPS REPRESENTED POPULATIONS OF COLOR, RECENT IMMIGRANT POPULATIONS, CULTURAL MINORITIES, THOSE WHO WERE AUDIBLY CHALLENGED AND OTHERS WHO WERE DEEMED TO BE UNDER-REPRESENTED OR UNDER-SERVED.
CENTRACARE HEALTH - PAYNESVILLEPART V, SECTION B, LINE 5: DATA WAS OBTAINED FROM LOCAL COUNTY PUBLIC HEALTH DEPARTMENTS, INCLUDING THEIR MOST RECENT HEALTH ASSESSMENTS AND COMMUNITY REPORTS. IN ADDITION, HEALTH-RELATED INFORMATION WAS COLLECTED FROM AREA NONPROFIT ORGANIZATIONS THAT REGULARLY CONDUCT ASSESSMENTS AND EVALUATIONS OF THE SERVICES THEY PROVIDE AND THEIR TARGETED DEMOGRAPHICS. USEFUL MATERIAL WAS GATHERED FROM THE LOCAL UNITED WAY, CATHOLIC CHARITIES, THE CENTRAL MINNESOTA COUNCIL ON AGING, AND THE TRI-COUNTY ACTION PROGRAM (TRI-CAP). THESE ORGANIZATIONS SUPPORT A BROAD RANGE OF CONSTITUENTS WITH DIVERSE HEALTH-RELATED NEEDS; THEY REPRESENT DEMOGRAPHICS THAT ARE STATISTICALLY MORE LIKELY TO ENCOUNTER HEALTH-RELATED BARRIERS. CCH ALSO CONDUCTED A SERIES OF FOCUS GROUPS THAT INFORMED ITS CHNA. SPECIFICALLY, THE FOCUS GROUPS REPRESENTED POPULATIONS OF COLOR, RECENT IMMIGRANT POPULATIONS, CULTURAL MINORITIES, THOSE WHO WERE AUDIBLY CHALLENGED AND OTHERS WHO WERE DEEMED TO BE UNDER-REPRESENTED OR UNDER-SERVED.
CENTRACARE HEALTH - MONTICELLOPART V, SECTION B, LINE 6A: CCH CONDUCTED ITS CHNA JOINTLY WITH ALL OF ITS 501(C)(3) HOSPITALS AS OF THE BEGINNING OF ITS FISCAL 2016. THOSE FACILITIES INCLUDED ST. CLOUD HOSPITAL, CENTRACARE HEALTH - MELROSE, CENTRACARE HEALTH - LONG PRAIRIE, CENTRACARE HEALTH - SAUK CENTRE, CENTRACARE HEALTH - MONTICELLO AND CENTRACARE HEALTH - PAYNESVILLE.EACH HOSPITAL PREPARED INDIVIDUAL ACTION PLANS TO THE CHNA BASED ON SPECIFIC INPUT FROM THOSE COMMUNITIES.
CENTRACARE HEALTH - PAYNESVILLEPART V, SECTION B, LINE 6A: CCH CONDUCTED ITS CHNA JOINTLY WITH ALL OF ITS 501 C 3 HOSPITALS AS OF THE BEGINNING OF ITS FISCAL 2016. THOSE FACILITIES INCLUDED ST. CLOUD HOSPITAL, CENTRACARE HEALTH MELROSE, CENTRACARE HEALTH LONG PRAIRIE, CENTRACARE HEALTH SAUK CENTRE, CENTRACARE HEALTH - MONTICELLO AND CENTRACARE HEALTH - PAYNESVILLE.EACH HOSPITAL PREPARED INDIVIDUAL ACTION PLANS TO THE CHNA BASED ON SPECIFIC INPUT FROM THOSE COMMUNITIES.
CENTRACARE HEALTH - PAYNESVILLEPART V, SECTION B, LINE 7D: IN ADDITION TO MAKING ITS CHNA AVAILABLE TO THE PUBLIC ON ITS WEB SITE AND AT ITS BUSINESS OFFICE, CCH HAS SHARED COPIES OF THE CHNA WITH COUNTY PUBLIC HEALTH OFFICIALS AND, INTERNALLY, WITH INDIVIDUALS WORKING ON QUALITY IMPROVEMENT AND COMMUNITY HEALTH INITIATIVES.CCH HAS ALSO PUBLISHED CONTACT INFORMATION FOR ITS DIRECTOR OF COMMUNITY & GOVERNMENT RELATIONS TO RESPOND TO QUESTIONS OR CONCERNS ABOUT THE CHNA. THE DIRECTOR HAS ALSO PRESENTED RESULTS OF THE CHNA TO COMMUNITY GROUPS AND TO REPRESENTATIVES OF LOCAL FUNDING GROUPS.
CENTRACARE HEALTH - MONTICELLOPART V, SECTION B, LINE 11: THE NEEDS IDENTIFIED BY THE CHNA ARE CURRENTLY IN ORGANIZATIONAL WORK PLANS AND ARE UNDER IMPLEMENTATION. TO PRIORITIZE IDENTIFIED NEEDS, CHNA ADVISORY TASK FORCE MEMBERS DEVISED A SET OF CRITERIA. THE CRITERIA USED WERE: COMMUNITY IMPACT, POTENTIAL FOR CHANGE, ECONOMIC FEASIBILITY, COMMUNITY ASSETS, AND VALUE AND MISSION. THE PRIORITIZATION PROCESS IDENTIFIED PROCESS IDENTIFIED THE FOLLOWING SIX, BROAD COMMUNITY HEALTH ISSUES: 1 - ADULT OBESITY2 - ADULT DIABETES3 - OLDER ADULT PREVENTABLE HOSPITALIZATIONS4 - STROKE DEATHS5 - CORONARY HEART DISEASE DEATHS6 - CANCER DEATHSCENTRACARE HEALTH WILL MAINTAIN ITS ENGAGEMENTS WITH THE CHNA ADVISORY TASK FORCE TO ENSURE EFFECTIVE COLLABORATION AND COMMUNICATION WITH THE OTHER CENTRACARE HOSPITALS. THE CHNA ADVISORY TASK FORCE WILL CONTINUE TO MEET DURING THE THREE-YEAR PERIOD IN WHICH THE IMPLEMENTATION STRATEGY WILL UNFOLD. DURING THIS TIME THE GROUP WILL:- IDENTIFY WHAT OTHER COMMUNITY ORGANIZATION ARE DOING IN REGARD TO HEALTH PRIORITY AREAS;- DEVELOP SPECIFIC GOALS AND METRICS TO MONITOR AND MEASURE PROGRESS AND OUTCOMES;- COMMUNICATE SHORT-TERM AND LONG-TERM RESULTS OF ACTION PLANS WITHIN THE COMMUNITY.BASED ON THE FINDINGS AND PRIORITIES ESTABLISHED BY THE CHNA, AND AFTER HAVING REVIEWED THE COMMUNITY BENEFITS ACTIVITIES THAT CURRENTLY EXIST, ST. CLOUD HOSPITAL WILL CONTINUE TO SUPPORT THE SYSTEM-WIDE INITIATIVES OUTLINED BELOW AND WILL PARTICIPATE IN LOCALIZED ADAPTATIONS (AS DESCRIBED IN THE ACTION STEPS) OF THESE PROGRAMS WITH REGARD TO THE SPECIFIC NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL. TO SEE THE SPECIFIC ACTION PLAN FOR EACH OF THE SIX PRIORITY HEALTH AREAS SEE THE FULL IMPLEMENTATION STRATEGY FOR FISCAL YEAR 2016 - 2018 LOCATED ON THE WEBSITE AT WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/2016-CENTRACARE-CHNA-AND-IMPELMENTATION-STRATEGIES.PDF.PER GUIDANCE FROM THE IRS, REGULATION 1.501(R)-3(C), THE CHNA FOR CCH ELECTED NOT TO DIRECTLY ADDRESS SEVERAL DETERMINANTS OF HEALTH THAT IT IDENTIFIED IN ITS PROCESS WHICH WERE NOT WITHIN THE ORGANIZATION'S CAPABILITIES OR CORE COMPETENCIES. EXAMPLES OF ISSUES NOT SPECIFICALLY ADDRESSED IN THE CHNA ACTION PLANS INCLUDE HIGH SCHOOL GRADUATION RATES, AFFORDABLE HOUSING OR SUPPORTED HOUSING. (CCH DID SUPPORT AN EFFORT OF THE CITY OF ST. CLOUD TO CONDUCT A HOUSING ASSESSMENT AS A RESULT OF THE CHNA PROCESS AND IS ALREADY THE LARGEST AREA PROVIDER OF SUPPORTED HOUSING DUE TO ITS EXTENSIVE CHEMICAL DEPENDENCY PROGRAMS AND SENIOR HOUSING PROGRAMS.)
CENTRACARE HEALTH - PAYNESVILLEPART V, SECTION B, LINE 11: THE NEEDS IDENTIFIED BY THE CHNA ARE CURRENTLY IN ORGANIZATIONAL WORK PLANS AND ARE UNDER IMPLEMENTATION. TO PRIORITIZE IDENTIFIED NEEDS, CHNA ADVISORY TASK FORCE MEMBERS DEVISED A SET OF CRITERIA. THE CRITERIA USED WERE: COMMUNITY IMPACT, POTENTIAL FOR CHANGE, ECONOMIC FEASIBILITY, COMMUNITY ASSETS, AND VALUE AND MISSION. THE PRIORITIZATION PROCESS IDENTIFIED PROCESS IDENTIFIED THE FOLLOWING SIX, BROAD COMMUNITY HEALTH ISSUES: 1 - ADULT OBESITY2 - ADULT DIABETES3 - OLDER ADULT PREVENTABLE HOSPITALIZATIONS4 - STROKE DEATHS5 - CORONARY HEART DISEASE DEATHS6 - CANCER DEATHSCENTRACARE HEALTH WILL MAINTAIN ITS ENGAGEMENTS WITH THE CHNA ADVISORY TASK FORCE TO ENSURE EFFECTIVE COLLABORATION AND COMMUNICATION WITH THE OTHER CENTRACARE HOSPITALS. THE CHNA ADVISORY TASK FORCE WILL CONTINUE TO MEET DURING THE THREE-YEAR PERIOD IN WHICH THE IMPLEMENTATION STRATEGY WILL UNFOLD. DURING THIS TIME THE GROUP WILL:- IDENTIFY WHAT OTHER COMMUNITY ORGANIZATION ARE DOING IN REGARD TO HEALTH PRIORITY AREAS;- DEVELOP SPECIFIC GOALS AND METRICS TO MONITOR AND MEASURE PROGRESS AND OUTCOMES;- COMMUNICATE SHORT-TERM AND LONG-TERM RESULTS OF ACTION PLANS WITHIN THE COMMUNITY.BASED ON THE FINDINGS AND PRIORITIES ESTABLISHED BY THE CHNA, AND AFTER HAVING REVIEWED THE COMMUNITY BENEFITS ACTIVITIES THAT CURRENTLY EXIST, ST. CLOUD HOSPITAL WILL CONTINUE TO SUPPORT THE SYSTEM-WIDE INITIATIVES OUTLINED BELOW AND WILL PARTICIPATE IN LOCALIZED ADAPTATIONS (AS DESCRIBED IN THE ACTION STEPS) OF THESE PROGRAMS WITH REGARD TO THE SPECIFIC NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL. TO SEE THE SPECIFIC ACTION PLAN FOR EACH OF THE SIX PRIORITY HEALTH AREAS SEE THE FULL IMPLEMENTATION STRATEGY FOR FISCAL YEAR 2016 - 2018 LOCATED ON THE WEBSITE AT WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/2016-CENTRACARE-CHNA-AND-IMPELMENTATION-STRATEGIES.PDF.PER GUIDANCE FROM THE IRS, REGULATION 1.501(R)-3(C), THE CHNA FOR CCH ELECTED NOT TO DIRECTLY ADDRESS SEVERAL DETERMINANTS OF HEALTH THAT IT IDENTIFIED IN ITS PROCESS WHICH WERE NOT WITHIN THE ORGANIZATION'S CAPABILITIES OR CORE COMPETENCIES. EXAMPLES OF ISSUES NOT SPECIFICALLY ADDRESSED IN THE CHNA ACTION PLANS INCLUDE HIGH SCHOOL GRADUATION RATES, AFFORDABLE HOUSING OR SUPPORTED HOUSING. (CCH DID SUPPORT AN EFFORT OF THE CITY OF ST. CLOUD TO CONDUCT A HOUSING ASSESSMENT AS A RESULT OF THE CHNA PROCESS AND IS ALREADY THE LARGEST AREA PROVIDER OF SUPPORTED HOUSING DUE TO ITS EXTENSIVE CHEMICAL DEPENDENCY PROGRAMS AND SENIOR HOUSING PROGRAMS.)
CENTRACARE HEALTH - MONTICELLOPART V, SECTION B, LINE 13H: A NON-CITIZEN CAN BE DENIED CARE IF THEY CAME TO THE US SPECIFICALLY TO RECEIVE FREE CARE. PRESUMPTIVE ELIGIBILITY - IF PATIENTS FAIL TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT FINANCIAL ASSISTANCE ELIGIBILITY, CENTRACARE HEALTH MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE ELIGIBILITY WHEN:(A) PATIENT IS HOMELESS(B) PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS(C) PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM(D) PATIENT IS ELIGIBLE FOR A STATE-FUNDED PRESCRIPTION MEDICATION PROGRAM(E) PATIENT'S VALID ADDRESS IS CONSIDERED LOW-INCOME OR SUBSIDIZED HOUSING(F) PATIENT RECEIVES FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO HOSPITAL FOR FURTHER TREATMENT
CENTRACARE HEALTH - PAYNESVILLEPART V, SECTION B, LINE 13H: A NON-CITIZEN CAN BE DENIED CARE IF THEY CAME TO THE US SPECIFICALLY TO RECEIVE FREE CARE. PRESUMPTIVE ELIGIBILITY - IF PATIENTS FAIL TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT FINANCIAL ASSISTANCE ELIGIBILITY, CENTRACARE HEALTH MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE ELIGIBILITY WHEN:(A) PATIENT IS HOMELESS(B) PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS(C) PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM(D) PATIENT IS ELIGIBLE FOR A STATE-FUNDED PRESCRIPTION MEDICATION PROGRAM(E) PATIENT'S VALID ADDRESS IS CONSIDERED LOW-INCOME OR SUBSIDIZED HOUSING(F) PATIENT RECEIVES FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO HOSPITAL FOR FURTHER TREATMENT
CARRIS HEALTH - RICE MEMORIAL HOSPITALPART V, SECTION B, LINE 13H: A NON-CITIZEN CAN BE DENIED CARE IF THEY CAME TO THE US SPECIFICALLY TO RECEIVE FREE CARE. PRESUMPTIVE ELIGIBILITY - IF PATIENTS FAIL TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT FINANCIAL ASSISTANCE ELIGIBILITY, CENTRACARE HEALTH MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE ELIGIBILITY WHEN:(A) PATIENT IS HOMELESS(B) PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS(C) PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM(D) PATIENT IS ELIGIBLE FOR A STATE-FUNDED PRESCRIPTION MEDICATION PROGRAM(E) PATIENT'S VALID ADDRESS IS CONSIDERED LOW-INCOME OR SUBSIDIZED HOUSING(F) PATIENT RECEIVES FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO HOSPITAL FOR FURTHER TREATMENT
CARRIS HEALTH - REDWOOD AREA HOSPITALPART V, SECTION B, LINE 13H: A NON-CITIZEN CAN BE DENIED CARE IF THEY CAME TO THE US SPECIFICALLY TO RECEIVE FREE CARE. PRESUMPTIVE ELIGIBILITY - IF PATIENTS FAIL TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT FINANCIAL ASSISTANCE ELIGIBILITY, CENTRACARE HEALTH MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE ELIGIBILITY WHEN:(A) PATIENT IS HOMELESS(B) PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS(C) PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM(D) PATIENT IS ELIGIBLE FOR A STATE-FUNDED PRESCRIPTION MEDICATION PROGRAM(E) PATIENT'S VALID ADDRESS IS CONSIDERED LOW-INCOME OR SUBSIDIZED HOUSING(F) PATIENT RECEIVES FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO HOSPITAL FOR FURTHER TREATMENT
CENTRACARE HEALTH - MONTICELLOPART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS.
CENTRACARE HEALTH - PAYNESVILLEPART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS.
CARRIS HEALTH - RICE MEMORIAL HOSPITALPART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS.
CARRIS HEALTH - REDWOOD AREA HOSPITALPART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS.
CENTRACARE HEALTH - MONTICELLO:PART V, SECTION B, LINES 7A AND 10A: THE HOSPITAL'S CHNA AND STRATEGY AND IMPLEMENTATION PLAN CAN BE FOUND ON ITS WEBSITE AT WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/2016-CENTRACARE-CHNA-AND-IMPELMENTATION-STRATEGIES.PDF.
CENTRACARE HEALTH - PAYNESVILLE:PART V, SECTION B, LINES 7A AND 10A: THE HOSPITAL'S CHNA AND STRATEGY AND IMPLEMENTATION PLAN CAN BE FOUND ON ITS WEBSITE AT WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/2016-CENTRACARE-CHNA-AND-IMPELMENTATION-STRATEGIES.PDF.
FieldValueIRS element (for citing)
Facility15FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (15 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - MONTICELLO CARE CENTER
1104 EAST RIVER STREETMONTICELLOMN55362SKILLED NURSING FACILITY
2 - MONTICELLO CLINIC
1001 HART BLVD STE 100MONTICELLOMN55362CLINIC
3 - KORONIS MANOR CARE CENTER
200 WEST FIRST STREETPAYNESVILLEMN56362SKILLED NURSING FACILITY
4 - CCH PAYNESVILLE- BELGRADE CLINIC
505 NELSON AVENUEBELGRADEMN56312CLINIC
5 - CCH PAYNESVILLE - COLD SPRING CLINIC
308 FIFTH AVENUE SOUTHCOLD SPRINGMN56320CLINIC
6 - CCH PAYNESVILLE - EDEN VALLEY CLINIC
405 MEEKER AVENUEEDEN VALLEYMN56362CLINIC
7 - CCH PAYNESVILLE - PAYNESVILLE CLINIC
200 WEST FIRST STREETPAYNESVILLEMN56362CLINIC
8 - CCH PAYNESVILLE - RICHMOND CLINIC
130 FIRST STREET NERICHMONDMN56368CLINIC
9 - RICE CARE CENTER
1801 WILLMAR AVE SWWILLMARMN56201SKILLED NURSING FACILITY
10 - RICE HOME MEDICAL
1033 19TH AVE SWWILLMARMN56201DURABLE MEDICAL EQUIPMENT PROVIDER
11 - CARRIS HEALTH SURGERY CENTER WILLMAR
1310 1ST STREET SWILLMARMN56201AMBULATORY SURGICAL CENTER
12 - CARRIS HEALTH-REDWOOD HEALTH PAVILION
1110 E BRIDGE STREDWOOD FALLSMN56283HOME CARE, HOSPICE AND ADULT DAY SERVICES
13 - CARRIS HEALTH - REDWOOD SEASONS HOUSE
400 VEDA DRREDWOOD FALLSMN56283ADULT FOSTER CARE WITH SERVICES (END OF LIFE CARE)
14 - RICE REHABILITATION CENTER
311 SW 3RD STWILLMARMN56201PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND SPEECH THERAPY
15 - MARSHALL SURGERY CENTER
1521 CARLSON ST 200MARSHALLMN56258OUTPATIENT SURGERY

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 6A:CENTRACARE HEALTH SYSTEM PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT THAT INCLUDES ALL RELATED ORGANIZATIONS.
PART I, LINE 7:THE HOSPITALS' TOTAL EXPENSES (NET OF BAD DEBT) WERE REDUCED BY OTHER OPERATING REVENUE (NET OF HER INCENTIVE REVENUE) AND ALSO BY MEDICAID SURCHARGE AND TAXES, AND THEN DIVIDED BY TOTAL PATIENT REVENUE TO DETERMINE COST TO CHARGE RATIO.
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 5,610,520.
PART III, LINE 2:THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS.
PART III, LINE 4:THE FOLLOWING IS FROM THE "ACCOUNTS RECEIVABLE" PARAGRAPH INCLUDED IN NOTE 2 OF THE ORGANIZATION'S AUDITED FINANCIALS."CENTRACARE REPORTS PATIENT AND RESIDENT SERVICE REVENUE AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH CENTRACARE EXPECTS TO BE ENTITLED TO IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS AND THIRD-PARTY PAYORS (INCLUDING MEDICARE, MEDICAID, BLUE CROSS AND OTHER THIRD-PARTY PAYORS). CERTAIN REIMBURSEMENT ARRANGEMENTS INCLUDE VARIABLE CONSIDERATION FOR AMOUNTS SUBJECT TO RETROACTIVE AUDIT AND ADJUSTMENT. DIFFERENCES BETWEEN AMOUNTS ORIGINALLY RECORDED AND FINALLY SETTLED ARE INCLUDED IN OPERATIONS IN THE YEAR IN WHICH THE DIFFERENCES ARE KNOWN. REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED."
PART III, LINE 8:THE SHORTFALL OF $4,850,090 IN TREATING MEDICARE PATIENTS SHOULD BE CONSIDERED A COMMUNITY BENEFIT IN ITS ENTIRETY. THE HOSPITALS PROVIDE AN EXCELLENT LEVEL OF CARE TO THE PEOPLE IN THE COMMUNITY. DESPITE THE SHORTFALL IN REIMBURSEMENT FORM MEDICARE, THE HOSPITALS CONTINUE TO PROVIDE ESSENTIAL HEALTHCARE SERVICES TO THE POPULATION. THE AMOUNT ON LINE 6 OF PART III WAS DETERMINED BY UTILIZING THE MEDICARE COST REPORT UTILIZING KEY SECTIONS OF THAT REPORT, PRIMARILY THE D SERIES AND E SERIES.
PART III, LINE 9B:THE COLLECTION POLICIES AT THE HOSPITALS REQUIRE COLLECTION STAFF TO OFFER CHARITY TO PATIENTS WHO INDICATE THAT PAYMENT MAY BE AN ISSUE. IF A PATIENT DOES QUALIFY FOR FULL CHARITY, ALL OTHER COLLECTION EFFORTS MUST CEASE, IF A PATIENT QUALIFIES FOR PARTIAL CHARITY, COLLECTION EFFORTS WILL CONTINUE ON THE BALANCE OF THE ACCOUNT. THESE PROVISIONS APPLY TO BOTH HOSPITAL EMPLOYED COLLECTION STAFF AND COLLECTION AGENCY STAFF. NO PATIENTS, WHETHER THEY QUALIFY FOR CHARITY OR NOT, ARE REPORTED TO CREDIT RATING AGENCIES.
PART VI, LINE 2:THE ORGANIZATIONS' STRATEGIC PLANNING ASSESSES THE NEEDS OF THE COMMUNITY AND PATIENTS THROUGH PATIENT SATISFACTION SURVEYS, COMMENT CARDS, COMMUNITY ASSESSMENTS AND A DIVERSE OPERATING COMMITTEE THAT REPRESENTS THE COMMUNITY AND BRINGS TO THE TABLE ISSUES, CONCERNS AND RECOMMENDATIONS FOR HEALTH CARE SERVICES.
PART VI, LINE 3:INPATIENTS WHO ARE SELF PAY ARE IDENTIFIED, AND A REPRESENTATIVE OF THE ORGANIZATION'S BILLING DEPARTMENT EXPLAINS THE CHARITY CARE POLICY TO PATIENTS. THEY ALSO EXPLAIN THE SELF PAY DISCOUNT AND SCREENS THE PATIENT FOR ELIGIBILITY FOR ANY STATE OR FEDERAL PROGRAMS. THEY ALSO ASSIST THE PATIENT WITH ANY PAPERWORK REQUIRED TO APPLY FOR SUCH PROGRAMS. OUTPATIENTS WHO ARE SELF PAY RECEIVE AN AUTOMATIC SELF PAY DISCOUNT. IF THE PATIENT DOES NOT REMIT PAYMENT, COLLECTION STAFF ATTEMPT TO REACH THE PATIENT BY PHONE. PATIENTS ARE TOLD ABOUT THE CHARITY PROGRAM. FOR BOTH INPATIENTS AND OUTPATIENTS, ALL STATEMENTS CONTAIN A LETTER REGARDING THE AVAILABILITY OF CHARITY CARE. ALSO ALL PRECOLLECTION LETTERS HAVE THIS SAME LANGUAGE INDICATING THE AVAILABILITY AND PROCESS OF OBTAINING CHARITY CARE.
PART VI, LINE 4:CENTRACARE HEALTH - MONTICELLO IS LOCATED IN CENTRAL MINNESOTA IN WRIGHT COUNTY. THE ESTIMATED 2019 CENSUS SHOWS A POPULATION OF 20,083, WITH A PROJECTED 2024 GROWTH PERCENTAGE OF 5.64% TO 21,215 POPULATION LEVEL. THIS AREA OF THE STATE IS SHOWING A SIGNIFICANT INCREASE IN POPULATION AND IS EXPECTED TO CONTINUE INTO THE FUTURE. THE PROJECTED GROWTH BY AGE BRACKET FROM 2019 TO 2024 IS AS FOLLOWS: 0-17: 2.40%, 18-44: 2.33%, 45-64: 6.61%, 65+: 20.52%. THE ESTIMATED 2019 ETHNIC MIX IS AS FOLLOWS: CAUCASIAN: 89.34%, AFRICAN AMERICAN: 1.52%, ASIAN: 1.08%, HISPANIC: 5.58%, OTHER: 2.48%. CENTRACARE HEALTH - PAYNESVILLE IS LOCATED IN CENTRAL MINNESOTA IN STEARNS COUNTY. THE ESTIMATED 2019 CENSUS SHOWS A POPULATION OF 6,242 AND IS PROJECTED TO INCREASE SLIGHTLY TO 6,379 BY 2024 WHICH REPRESENTS A 2.19% INCREASE. THE PROJECTED GROWTH BY AGE BRACKET FROM 2019 TO 2024 IS AS FOLLOWS: 0-17: 2.80%, 18-44: 5.21%, 45-64: -7.11%, 65+: 7.65%. THE ESTIMATED 2019 ETHNIC MIX IS AS FOLLOWS: CAUCASIAN: 95.79%, AFRICAN AMERICAN: .46%, ASIAN: .43%, HISPANIC: 2.27%, OTHER: 1.04%. CARRIS HEALTH, LLC IS LOCATED IN CENTRAL MINNESOTA IN KANDIYOHI COUNTY. THE 2019 CENSUS BUREAU ESTIMATES POPULATION OF 43,199 AS OF JULY 2019 AND IS PROJECTED TO INCREASE 0.31% BY 2023. THE PROJECTED GROWTH BY AGE BRACKET FROM 2018 TO 2023 IS AS FOLLOWS: 0-17: 1.5%, 18-44: 3.9%, 45-64: -8.1%, 65+: 8.3%. THE ESTIMATED 2019 ETHNIC MIX IS AS FOLLOWS: CAUCASIAN: 79.6%, AFRICAN AMERICAN: 6.2%, ASIAN: 1.1%, HISPANIC: 12.3%, OTHER: 0.8%
PART VI, LINE 5:THE ORGANIZATION PROMOTES THE HEALTH OF THE COMMUNITY IN SEVERAL IMPORTANT WAYS. ONE OF THESE WAYS IS THROUGH THE COMMUNITY COLLABORATION COMMITTEE (CCC), A STANDING COMMITTEE OF THE CENTRACARE HEALTH FOUNDATION. THE CCC HAS A MEMBERSHIP OF OVER 30 PERSONS REPRESENTING HEALTHCARE AND COMMUNITY NEEDS ACROSS CENTRAL MINNESOTA. THE CCC MEETS MONTHLY TO DISCUSS WAYS TO ADDRESS TYPICAL HEALTH ISSUES THROUGH AWARENESS BUILDING, EDUCATION AND/OR AN INTERVENTION PROJECT. THERE ARE SEVERAL COMMUNITY HEALTH OUTREACH INITIATIVES THAT THE FOUNDATION IS INVOLVED WITH. THESE INITIATIVES INCLUDE: 1) BLEND CHILDHOOD OBESITY COALITION OF CENTRAL MINNESOTA, 2) SMOKE FREE COMMUNITIES (CONTINUED EFFORTS TO CREATE CLEAN INDOOR AND OUTDOOR AIR FOR ALL), 3) TOBACCO CESSATION SERVICES CLINICS (COLLABORATION WITH CLINIC), 4) CENTRACARE CLINIC TEAM BASED CARE PILOT, 5) ST. CLOUD HOSPITAL - TRANSITION OF CARE PILOT (CREATE MORE SEAMLESS INTEGRATION FROM CARE SETTING TO CARE SETTING, AND 6) CLINIC - DIVERSITY AND CULTURAL COMPETENCY TRAINING.
PART VI, LINE 6:THE ORGANIZATION IS PART OF CENTRACARE HEALTH SYSTEM (CCHS) WHICH PROVIDES A BROAD RANGE OF HEALTH CARE SERVICES TO THE PATIENTS OF CENTRAL MINNESOTA. CCHS IS DEDICATED TO IMPROVING THE HEALTH OF PEOPLE LIVING AND WORKING IN THE COMMUNITIES IT SERVES. TO ACCOMPLISH ITS GOALS IT WORKS ACTIVELY WITH ITS AFFILIATE HEALTH CARE ORGANIZATIONS. CCHS CONTINUES TO FOCUS ON PROVIDING THE BEST CARE POSSIBLE AND IN REINVESTING INTO THE COMMUNITY. CCHS ALSO PROMOTES WELLNESS BY SPONSORING PROGRAMS AND EVENTS IN LOCAL COMMUNITIES THAT FOCUS ON HEALTHY EATING AND EXERCISE, AND BY CONDUCTING SCREENINGS FOR CONDITIONS SUCH AS HIGH BLOOD PRESSURE.
PART VI, LINE 7, REPORTS FILED WITH STATESMN

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
ST CLOUD STATE UNIVERSITY
720 FOURTH AVE SOUTHST CLOUDMN56301411687554STATE GOVERNMENT$17,500MARTIN LUTHER KING BREAKFAST & DAY OF SERVICE - KEYNOTE SPEAKER
UNITED WAY
921 1ST ST N STE 200ST CLOUDMN56303410915124501(C)(3)$10,400TO HELP THE COMMUNITIES MOST CRITICAL HUMAN SERVICES ISSUES.
CITY OF ST CLOUD
400 SECOND ST SST CLOUDMN56301416005515STATE GOVERNMENT$10,000CITY SUPPORT IN WORKFORCE DISPLACEMENT
COMMUNITYGIVING
101 7TH AVE SOUTHST CLOUDMN56302363412544501(C)(3)$6,000PLEDGE CONTRIBUTION -JUGAAD LEADERSHIP PROGRAM
FieldValueIRS element (for citing)
Total501c3 Org4Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPSGrantTypeTxt
Cash Grant$33,229CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationCENTRACARE HEALTH SYSTEM HAS THE FOLLOWING POLICY REGARDING CHARITABLE CONTRIBUTIONS: CONTRIBUTIONS MUST BE IN KEEPING WITH THE MISSION OF CENTRACARE HEALTH, WHICH IS TO WORK TO IMPROVE THE HEALTH OF EVERY PATIENT, EVERY DAY. CONTRIBUTIONS WILL BE MADE TO ORGANIZATIONS RATHER THAN TO INDIVIDUALS WITHIN THE CENTRAL MINNESOTA REGION. CENTRACARE'S CHARITABLE FUNDS MAY NOT BE USED TO SUPPORT ANY ORGANIZATION OR EVENT THAT WOULD RESULT IN BENEFITS OF ANY KIND TO AN EMPLOYEE OF THE HEALTH SYSTEM OR A MEMBER OF THE VARIOUS BOARDS OF DIRECTORS, EITHER DIRECTLY OR INDIRECTLY. ONE EXCEPTION EXISTS TO THE GUIDELINE REGARDING BENEFIT TO EMPLOYEES: WE WILL SUPPORT, VIA SCHOLARSHIPS AND THE PURCHASE OF SUPPLIES, THE MEDICAL MISSION WORK OF OUR STAFF AND PHYSICIANS. THE CENTRACARE HEALTH CONTRIBUTIONS COMMITTEE IS MADE UP OF: ONE REPRESENTATIVE FROM CENTRACARE HEALTH FOUNDATION; ONE REPRESENTATIVE FROM ST. CLOUD HOSPITAL HUMAN RESOURCES/DIVERSITY COMMITTEE; THE DIRECTOR OF CENTRACARE HEALTH'S COMMUNICATION DEPARTMENT AND THE COMMUNICATIONS/MARKETING FOR ST. BENEDICT'S SENIOR COMMUNITY; THE DIRECTOR OF CENTRACARE HEALTH'S MARKETING DEPARTMENT; THE DIRECTOR OF ST. CLOUD HOSPITAL VOLUNTEER SERVICES; AND ST. CLOUD HOSPITAL'S DIRECTOR OF MISSION & SPIRITUAL CARE. THE COMMITTEE MEETS MONTHLY TO ENSURE A STREAMLINED, COORDINATED PROCESS OF REVIEWING REQUESTS AND DETERMINING FUNDING. THE COMMITTEE MAINTAINS A DATABASE TO TRACK ALL CONTRIBUTIONS. OTHER CENTRACARE ENTITIES, INCLUDING CENTRACARE HEALTH - LONG PRAIRIE, MELROSE, MONTICELLO, PAYNESVILLE AND SAUK CENTRE, MAY DEVELOP A BUDGET FOR APPROVAL AND IMPLEMENT THEIR OWN CONTRIBUTIONS DECISIONS WITHIN THE GUIDELINES OF THIS DOCUMENT. CONTRIBUTIONS MAY NOT EXCEED THE STATED BUDGET AND NO MULTI-YEAR COMMITMENTS TO ORGANIZATIONS MAY BE MADE WITHOUT APPROVAL FORM THE CENTRACARE HEALTH EXECUTIVE COUNCIL. INDIVIDUALS AND DEPARTMENTS FORM THROUGHOUT ST. CLOUD HOSPITAL AND CENTRACARE CLINIC SHOULD FORWARD ALL OUTSIDE FUNDING REQUESTS TO A MEMBER OF THE COMMITTEE FOR THE FULL GROUP'S CONSIDERATION. THOSE REQUESTING FUNDS SHOULD BE ASKED TO SUBMIT REQUESTS IN WRITING.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (1)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (32 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KENNETH D HOLMEN MD
PRESIDENT/CEO$1,173,232$0$262,499$0$19,719$0$11,687$0$18,207$0$1,485,344$0$0$0
DONALD JURGENS MD
DIRECTOR/PHYSICIAN$0$871,415$0$11,533$0$27,807$0$20,625$0$17,960$0$949,340$0$0
BRYAN ROLPH
DIRECTOR/PHYSICIAN$0$418,884$0$16,533$0$9,322$0$21,873$0$28,719$0$495,331$0$0
SHARON RUGGIERO MD
DIRECTOR/PHYSICIAN$0$219,479$0$18,544$0$26,371$0$18,740$0$10,302$0$293,436$0$0
CHRISTIAN SCHMIDT MD
DIRECTOR/SURGEON$0$635,518$0$14,221$0$28,699$0$20,625$0$25,940$0$725,003$0$0
RICHARD WEHLSER MD
DIRECTOR/PHYSICIAN$0$224,432$0$155,205$0$1,786$0$5,882$0$9,994$0$397,299$0$0
PAUL R HARRIS ESQ
CORPORATE SECRETARY$390,662$0$85,223$0$97,654$0$105,471$0$204,905$0$883,915$0$66,403$0
GREGORY R KLUGHERZ
TREASURER/CFO$622,849$0$113,782$0$19,794$0$16,500$0$17,607$0$790,532$0$0$0
CHRISTOPHER BOELTER MD
VICE PRESIDENT$597,251$0$40,836$0$18,902$0$20,625$0$2,921$0$680,535$0$0$0
JOSEPH M BLONSKI MD
VICE PRESIDENT$369,763$0$71,901$0$14,376$0$77,187$0$135,771$0$668,998$0$0$0
DIANE R BUSCHENA-BRENNA
VICE PRESIDENT$185,485$0$12,733$0$3,978$0$14,963$0$17,874$0$235,033$0$0$0
ANTHONY V GARDENER
VICE PRESIDENT$240,906$0$59,130$0$59,367$0$58,370$0$97,301$0$515,074$0$0$0
JOSEPH D HELLIE
VICE PRESIDENT$0$279,678$0$51,713$0$42,018$0$71,606$0$117,596$0$562,611$0$0
BETH A HONKOMP
VICE PRESIDENT$263,607$0$42,920$0$2,974$0$19,701$0$18,293$0$347,495$0$0$0
JOSEPH H KALKMAN
VICE PRESIDENT$310,687$0$59,202$0$23,742$0$50,875$0$122,259$0$566,765$0$0$0
BRADLEY J KONKLER
VICE PRESIDENT$229,483$0$42,333$0$52,313$0$55,536$0$109,792$0$489,457$0$0$0
DAVID A LARSON
VICE PRESIDENT$0$183,344$0$17,073$0$5,760$0$34,317$0$69,054$0$309,548$0$0
KELLY MACKEN-MARBLE
VICE PRESIDENT$265,348$0$62,912$0$39,772$0$46,439$0$90,167$0$504,638$0$0$0
MARK S MATTHIAS MD
VICE PRESIDENT$487,386$0$81,639$0$91,407$0$32,623$0$50,538$0$743,593$0$0$0
GEORGE A MORRIS MD
VICE PRESIDENT$395,524$0$81,707$0$34,688$0$69,378$0$121,315$0$702,612$0$0$0
KURT OTTO MD
VICE PRESIDENT$278,833$0$55,204$0$62,539$0$71,717$0$135,555$0$603,848$0$23,611$0
KATHLEEN M PARSONS
VICE PRESIDENT$261,395$0$35,656$0$774$0$40,090$0$52,686$0$390,601$0$0$0
JOY PLAMANN
VICE PRESIDENT$259,332$0$48,279$0$10,342$0$69,904$0$117,819$0$505,676$0$0$0
AMY M PORWOLL
VICE PRESIDENT$346,204$0$66,252$0$84,619$0$87,164$0$157,675$0$741,914$0$0$0
MICHAEL W SCHRAMM
CARRIS HEALTH, PRESIDENT/CO-CEO$339,022$0$99,804$0$443$0$30,881$0$56,771$0$526,921$0$0$0
THOMAS SCHRUP MD
VICE PRESIDENT$368,446$0$82,829$0$6,576$0$63,495$0$105,928$0$627,274$0$0$0
CINDY FIRKINS SMITH MD
CARRIS HEALTH, PRESIDENT/CO-CEO$0$533,198$0$276,560$0$1,290$0$54,860$0$100,366$0$966,274$0$0
NELSON L ADAMSON MD
PHYSICIAN$0$511,320$0$6,511$0$28,740$0$20,625$0$21,635$0$588,831$0$0
JONATHAN W MELLEMA MD
PHYSICIAN$0$235,417$0$346,363$0$300$0$8,539$0$8,094$0$598,713$0$0
LEAH M SCHAMMEL MD
PHYSICIAN$0$205,000$0$489,939$0$18,770$0$10,482$0$8,844$0$733,035$0$0
JULIE C SCHULTZ MD
PHYSICIAN$0$155,538$0$524,164$0$18,950$0$10,022$0$15,586$0$724,260$0$0
NATHANIEL J SLINKARD MD
PHYSICIAN$0$419,732$0$212,500$0$270$0$2,730$0$7,344$0$642,576$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 4BTHE CORPORATIONS' EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN BENEFIT PLANS WHICH INCLUDE TAX DEFERRRED NON-QUALIFIED INVESTMENT ACCOUNTS. THESE PLANS MAY PROVIDE, BUT ARE NOT CERTAIN TO PROVIDE, FOR PAYMENT OF TAX DEFERRED COMPENSATION TO THESE EXECUTIVES AT SOME TIME IN THE FUTURE. THE EXECUTIVE HAS NO LEGAL RIGHT TO THESE DOLLARS UNTIL, AND UNLESS, CERTAIN FUTURE EVENTS OCCUR. IN ACCORDANCE WITH THE INSTRUCTIONS TO THE FORM 990, THE AMOUNTS LISTED IN SECTION VII AND IN SCHEDULE J REFLECT THIS TAX DEFERRED COMPENSATION. THIS COMPENSATION IS POTENTIALLY REPORTED TWICE ON THE FORM 990. ONCE WHEN THE COMPENSATION IS DEFERRED OR ACCRUED AND AGAIN IF IT IS PAID TO THE EXECUTIVE. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED PLAN: PAUL R HARRIS - PAID $66,403; ACCRUED $88,628 CINDY FIRKINS SMITH, MD - PAID $0; ACCRUED $43,281 AMY M PORWOLL - PAID $57,341; ACCRUED $66,313 THOMAS SCHRUP - PAID $0; ACCRUED $42,705 KELLY MACKEN-MARBLE - PAID $0; ACCRUED $37,781 KURT OTTO - PAID $43,625; ACCRUED $54,854 JOY PLAMANN - PAID $0; ACCRUED $47,972 MARK S MATTHIAS, MD - PAID $71,719; ACCRUED $16,122 KENNETH D HOLMEN - PAID $0; ACCRUED $0 GREGORY R KLUGHERZ - PAID $0; ACCRUED $0 GEORGE A MORRIS, MD - PAID $30,897; ACCRUED $47,483 JOSEPH M BLONSKI, MD - PAID $0; ACCRUED $54,527 JOSEPH H KALKMAN - PAID $0; ACCRUED $50,875 ANTHONY V GARDENER - PAID $43,886; ACCRUED $44,496 BRADLEY J KONKLER - PAID $47,166; ACCRUED $42,372 DAVID A LARSON - PAID $0; ACCRUED $22,065 JOSEPH D HELLIE - PAID $41,604; ACCRUED $51,408 KATHLEEN M PARSONS - PAID $0; ACCRUED $18,629
PART I, LINE 6THE ORGANIZATION PROVIDES INCENTIVE COMPENSATION TO DESIGNATED INDIVIDUALS BASED ON FOUR DISCRETE AREAS: STEWARDSHIP, THROUGH A COMPARISON BETWEEN BUDGETED AND ACTUAL NET OPERATING INCOME FOR SAINT CLOUD HOSPITAL AND/OR CENTRACARE HEALTH SYSTEM AS WELL THROUGH ACHIEVING METRICS FOR AN IDENTIFIED COST REDUCTION PROGRAM; QUALITY, THROUGH ACHIEVING SAINT CLOUD HOSPITAL AND SYSTEM QUALITY METRICS; PATIENT EXPERIENCE, THROUGH ACHIEVEMENT OF PATIENT SATISFACTION GOALS AS COMPARED TO NATIONAL AND BASELINE RANKINGS; AND PEOPLE/EMPLOYEES, THROUGH ACHIEVEMENT OF SPECIFIED EMPLOYMENT SATISFACTION GOALS AND HIRING AND/OR RETENTION GOALS. THE INCENTIVE COMPENSATION PAID OUT IS NOT A PORTION OR PERCENTAGE OF ACTUAL NET EARNINGS OF ANY CENTRACARE HEALTH SYSTEM AFFILIATE, HOWEVER NET EARNINGS GOALS ARE REQUIRED TO BE MET BEFORE THE INCENTIVE COMPENSATION IS PAID.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingIndCUSIPCUSIPNum
THE CITY OF ST CLOUD
A4160055152011-12-28$31,445,000HEALTH CARE REVENUE BONDS 2011B000
THE CITY OF ST CLOUD
B4160055152014-11-19$48,876,925HEALTH CARE REVENUE BONDS 2014B00078916VCZ1
THE CITY OF ST CLOUD
C4160055152014-08-01$128,310,000HEALTH CARE REVENUE BONDS 2014000
THE CITY OF ST CLOUD
D4160055152016-05-12$216,598,436HEALTH CARE REVENUE BONDS 2016A00078916VDR8

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtRefunding EscrowRefundingEscrowAmt
A$31,445,000$31,445,0002012Yes (1)0Yes (1)Yes (1)
B$48,876,925$48,325,94420100Yes (1)Yes (1)Yes (1)$550,981
C$128,310,000$113,310,0002016Yes (1)0Yes (1)Yes (1)$15,000,000
D$216,598,43620170Yes (1)Yes (1)Yes (1)$1,760,260$53,357,670$161,480,506

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdIndEngage Bond Counsel ResearchEngageBondCounselResearchInd
A00000.006700.0067000Yes (1)
B0Yes (1)0Yes (1)0.024000.0240000Yes (1)Yes (1)
C0Yes (1)000.006500.0065000Yes (1)
D0Yes (1)0Yes (1)0.019000.0190000Yes (1)Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A00Yes (1)Yes (1)0000Yes (1)
B000Yes (1)0000Yes (1)
C000Yes (1)Yes (1)000Yes (1)
D0Yes (1)000000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)
CYes (1)
DYes (1)

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceDATE REBATE COMPUTATION PERFORMEDFormAndLineReferenceDesc
ExplanationISSUER NAME: THE CITY OF ST CLOUD DATE THE REBATE COMPUTATION WAS PERFORMED: 02/23/2017 ISSUER NAME: THE CITY OF ST CLOUD DATE THE REBATE COMPUTATION WAS PERFORMED: 07/23/2019 ISSUER NAME: THE CITY OF ST CLOUD DATE THE REBATE COMPUTATION WAS PERFORMED: 07/09/2019ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1THE CITY OF ST CLOUDBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN416005515BondIssuerEIN
CUSIP78916VDW7CUSIPNum
Bond Issued2019-03-28BondIssuedDt
Issue Price$143,227,442IssuePriceAmt
PurposeHEALTH CARE REVENUE BONDS 2019PurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$14,322,744TotalProceedsAmt
Issuance Costs From Proceeds$1,512,827IssuanceCostsFromProceedsAmt
Capital Expenditures$20,131,722CapitalExpendituresAmt
Other Spent Proceeds$8,156,941OtherSpentProceedsAmt
Refunding Tax Exempt BondsYes (1)RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease ArrangementsYes (1)AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research AgreementsYes (1)AnyResearchAgreementsInd
Engage Bond Counsel ResearchYes (1)EngageBondCounselResearchInd
Private Bus Concerning UBI0.00830PrivateBusConcerningUBIPct
Total Private Business Use0.00830TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due YetYes (1)RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 2IN JANUARY 2019, REDWOOD AREA HOSPITAL IN REDWOOD FALLS, MINN. AND FAMILY PRACTICE MEDICAL CENTER IN WILLMAR, MINN. JOINED CARRIS HEALTH. CARRIS HEALTH IS COMMITTED TO STRENGTHENING HEALTH CARE IN WEST CENTRAL AND SOUTHWEST MINNESOTA BY PARTNERING WITH ORGANIZATIONS THAT SHARE THE SAME PASSION FOR RURAL HEALTH CARE.
FORM 990, PART VI, SECTION B, LINE 11BTHE BOARD OF DIRECTORS HAS DELEGATED THE APPROVAL AUTHORITY OF THE FORM 990 TO THE AUDIT COMMITTEE. ANNUALLY, AT THE AUDIT COMMITTEE MEETING, PRIOR TO FILING WITH THE IRS, THE AUDIT COMMITTEE REVIEWS AND APPROVES FORM 990. A COPY OF FORM 990 IS THEN PROVIDED FOR THE FULL BOARD TO REVIEW PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE BOARD MEMBERS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE TWICE A YEAR. ALL STAFF SIGN CONFLICTS OF INTEREST FORMS ON AN ANNUAL BASIS. THE QUESTIONNAIRES ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AS WELL AS THE CORPORATE COMPLIANCE GROUP (A COMPLIANCE COMMITTEE WHICH INCLUDES INTERNAL MEMBERS AND OUTSIDE COUNSEL). THE RESPONSES TO THE QUESTIONNAIRES ARE THEN REVIEWED WITH THE EXECUTIVE COMMITTEE OF THE BOARD. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING CONFLICTS OF INTERESTS RELATED TO BOARD AND STAFF AND TO ALERT AFFECTED PARTIES WHEN A CONFLICT ARISES. WHEN AN ACTUAL CONFLICT ARISES, THE AFFECTED PARTY IS ASKED TO RECUSE HIM/HER SELF FROM THE DECISION MAKING PROCESS. THE CORPORATE COMPLIANCE OFFICER ATTENDS BOARD MEETINGS AND SPECIFIED BOARD COMMITTEE MEETINGS WHERE CONFLICT ISSUES MAY ARISE.
FORM 990, PART VI, SECTION B, LINE 15THE COMPENSATION AND BENEFITS OF THE PRESIDENT AND THE VICE PRESIDENTS (NON-MEDICAL PROVIDERS) ARE SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT REQUIRED BY LAW TO BE MADE AVAILABLE TO THE PUBLIC AND CENTRACARE HEALTH SYSTEM DOES NOT MAKE THEM AVAILABLE.
FORM 990, PART IX, LINE 11GMEDICAL/OTHER FEES: PROGRAM SERVICE EXPENSES 14,287,299. MANAGEMENT AND GENERAL EXPENSES 3,900,790. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,188,089. CONTRACTED SERVICES/PURCH SVCS: PROGRAM SERVICE EXPENSES 48,074,368. MANAGEMENT AND GENERAL EXPENSES 13,125,503. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 61,199,871.
FORM 990, PART XI, LINE 9:PENSION PLAN ADJUSTMENT -92,083. NET EQUITY TRANSFERS TO RELATED ORGS 14,150,266. MONTICELLO NET NON-CONTROLLING INTEREST (DISTRIBUTION & NET INCOME -2,161,672. BENEFICIAL INTEREST IN FOUNDATION 1,059,909. CONTRIBUTED NA OF AFFILIATIONS 25,756,622. OTHER CHANGES IN NET ASSETS -1,678,376.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
CENTRACARE SURGERY CENTER LLC
1406 6TH AVE NST CLOUDMN56303611514974SURGICAL CENTERMN$12,478,642$5,776,676CENTRACARE HEALTH SYSTEM
CENTRACARE HEALTH - MONTICELLO
1013 HART BLVDMONTICELLOMN55362461584944HEALTHCAREMN$75,164,401$62,472,597CENTRACARE HEALTH SYSTEM
CENTRACARE HEALTH - PAYNESVILLE
200 W200 WEST FIRST STREETPAYNESVILLEMN56362433298651HEALTHCAREMN$43,971,576$30,427,655CENTRACARE HEALTH SYSTEM
CENTRAL MINNESOTA HEALTH NETWORK LLC (FKA CIN LLC)
1406 6TH AVE NST CLOUDMN56303473924684CLINICAL INEGRATED NETWORKMN$0-$1,343,414CENTRACARE HEALTH SYSTEM
CENTRAL MINNESOTA ACO LLC
1406 6TH AVE NST CLOUDMN56303474591476ACCREDITED CARE ORGANIZATIONMN$13,689-$658,007CENTRACARE HEALTH SYSTEM
CARRIS HEALTH LLC
301 BECKER AVE SWWILLMARMN56201823166379HEALTH CARE SYSTEMMN$181,954,535$279,207,472CENTRACARE HEALTH SYSTEM
CENTRAL MINNESOTA IHP LLC
1406 6TH AVE NST CLOUDMN56303HEALTHCAREMN$0$0CENTRACARE HEALTH SYSTEM
ALBANY CLINIC PROPERTY LLC
1406 6TH AVE NST CLOUDMN56303HEALTHCAREMN$0$0CENTRACARE HEALTH SYSTEM
CENTRACARE PROVIDER SERVICES LLC
1406 6TH AVE NST CLOUDMN56303HEALTHCAREMN$0$0CENTRACARE HEALTH SYSTEM

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
ST CLOUD HOSPITAL
1406 6TH AVE NST CLOUDMN56303410695596ACUTE/LT CAREMN501(C)(3)LINE 3CENTRACARE HEALTH SYSTEMYes (1)
CENTRACARE HEALTH-MELROSE
11 NORTH 5TH AVE WESTMELROSEMN56352411865315ACUTE/LT CAREMN501(C)(3)LINE 3CENTRACARE HEALTH SYSTEMYes (1)
CENTRACARE HEALTH-LONG PRAIRIE
50 CENTRACARE DRIVELONG PRAIRIEMN56347411924645ACUTE/LT CAREMN501(C)(3)LINE 3CENTRACARE HEALTH SYSTEMYes (1)
CENTRACARE HEALTH-SAUK CENTRE
425 ELM STREET NORTHSAUK CENTREMN56378452438973ACUTE/LT CAREMN501(C)(3)LINE 3CENTRACARE HEALTH SYSTEMYes (1)
CENTRACARE CLINIC
1200 6TH AVE NORTHST CLOUDMN56303411806657MULTI-SPECIALTYMN501(C)(3)LINE 3CENTRACARE HEALTH SYSTEMYes (1)
CENTRACARE HEALTH FOUNDATION
1406 6TH AVE NST CLOUDMN56303411855173FUNDRAISINGMN501(C)(3)LINE 7CENTRACARE HEALTH SYSTEMYes (1)
CUSHMAN ALBERT RICE TRUST
1100 WEST ST GERMAIN STREETST CLOUDMN56303416019335SUPPORT FOR RICE MEMORIAL HOSPITALMN501(C)(3)LINE 12A, IRICE MEMORIAL HOSPITAL0
RICE HEALTH FOUNDATION
301 BECKER AVE SWWILLMARMN56303411611555SUPPORT FOR RICE MEMORIAL HOSPITALMN501(C)(3)LINE 12A, IRICE MEMORIAL HOSPITAL0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPct
MONTICELLO CANCER CENTER
1001 HART BLVD STE 50MONTICELLOMN55362261909519RADIATION & ONCOLOGY SERVICESMNCENTRACARE HEALTH SYSTEM - MONTICELLORELATED$7,560,903$5,835,3430Yes (1)0.60000
MONTICELLO SURGERY CENTER
1013 HART BLVDMONTICELLOMN55362813593057AMBULATORY SURGERY CENTERMNCENTRACARE HEALTH SYSTEMRELATED-$123,602$3,884,7590Yes (1)0.43550

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
CENTRACARE HOLDINGS INC
1406 6TH AVE NST CLOUDMN56303472688595INVESTMENTS/PHARMACYMNCENTRACARE HEALTH SYSTEMC$6,343,102$5,321,2401.00000Yes (1)
AFFILIATED COMMUNITY MEDICAL CENTERS PA
301 BECKER AVE SWWILLMARMN56201HEALTH CARE SYSTEMMNCARRIS HEALTH LLCC$99,142,963$127,469,7251.000000
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (20 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
CENTRACARE HEALTH - LONG PRAIRIE
A$39,678ARMS LENGTH
CENTRACARE HOLDINGS INC
A$69,870ARMS LENGTH
CENTRACARE CLINIC
A$6,649,473ARMS LENGTH
ST CLOUD HOSPITAL
A$148,022ARMS LENGTH
CENTRACARE HEALTH - LONG PRAIRIE
D$1,838,092ARMS LENGTH
CENTRACARE CLINIC
O$108,479ARMS LENGTH
ST CLOUD HOSPITAL
P$1,920,895ARMS LENGTH
CENTRACARE CLINIC
P$117,171ARMS LENGTH
CENTRACARE HEALTH - LONG PRAIRIE
Q$3,361,668ARMS LENGTH
CENTRACARE HEALTH - MELROSE
Q$3,556,740ARMS LENGTH
CENTRACARE HEALTH - SAUK CENTRE
Q$2,996,700ARMS LENGTH
CENTRACARE HOLDINGS INC
Q$306,816ARMS LENGTH
CENTRACARE CLINIC
Q$28,521,984ARMS LENGTH
ST CLOUD HOSPITAL
Q$75,571,344ARMS LENGTH
CENTRACARE CLINIC
R$31,763,370ARMS LENGTH
CENTRACARE HOLDINGS INC
R$2,104,500ARMS LENGTH
CENTRACARE HEALTH - LONG PRAIRIE
S$127,442ARMS LENGTH
CENTRACARE HEALTH - SAUK CENTRE
S$1,707,474ARMS LENGTH
CENTRACARE HEALTH - MELROSE
S$3,332,171ARMS LENGTH
ST CLOUD HOSPITAL
S$48,068,976ARMS LENGTH

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